Let’s face it—taking a pill every day isn’t everyone’s thing. Whether it’s forgetfulness, pill fatigue, stigma, or just plain inconvenience, traditional oral PrEP (pre-exposure prophylaxis) isn’t a perfect fit for all. That’s why the approval of injectable PrEP options marks a major leap forward in HIV prevention, especially for gay men, trans women, and others who are at elevated risk and navigating busy lives, complex routines, or just want to keep things simple.
And as of this month, we now have two long-acting injectable options available—including one that only needs to be given twice a year.
What Are the Injectable PrEP Options?
As of July 2025, the FDA has approved two injectable PrEP options:
💉 Cabotegravir (Apretude)
An integrase inhibitor approved in 2021.
Given every 2 months after an initial loading phase.
Administered by a healthcare provider—no self-injection option.
Has been shown to be more effective than oral PrEP in some populations, especially young Black gay and bisexual men and trans women.
💉 Lenacapavir
Just approved this month for HIV PrEP.
A capsid inhibitor with a unique mechanism of action.
Requires only two injections a year—a huge convenience for many.
Also administered by a provider, making it a discreet and long-lasting option.
Why Injectable PrEP Is a Big Deal
Having two distinct injectable options is a huge win for prevention:
More choices means better chances of finding the right fit.
Longer dosing intervals, especially with lenacapavir, mean fewer appointments.
Expanded options may reduce barriers to adherence and increase uptake in high-risk groups.
New drug classes, like lenacapavir’s capsid inhibition, offer additional tools for long-term HIV prevention.
✅ Benefits of Injectable PrEP
No daily pills: Great for those who forget, travel often, or prefer not to carry meds.
Discreet: No visible medications lying around to invite questions or stigma.
Highly effective: Both options have shown strong protection when used as directed.
Less medical burden: Especially with lenacapavir’s 6-month dosing, patients don’t have to think about HIV prevention every day.
🚧 Risks and Limitations
Injection site reactions are common but usually mild and temporary.
Appointment timing matters: Missing doses or delaying injections can leave you vulnerable and at risk for resistance.
Resistance risk: If HIV infection happens during the “tail” period—when drug levels are low but still present—it may lead to resistance, particularly for integrase or capsid inhibitors.
Still clinic-based: Neither option is self-injectable, so you need reliable access to a provider.
Not for everyone: People with needle phobia or highly mobile lifestyles may still prefer oral PrEP or on-demand strategies.
Who Might Prefer Lenacapavir?
Lenacapavir is especially attractive for:
People who want maximum convenience with just two injections a year.
Those who don’t tolerate integrase inhibitors well.
Anyone with trouble sticking to more frequent dosing schedules.
Folks who want a set-it-and-forget-it approach to HIV prevention.
How to Access Injectable PrEP
Talk to your provider – Not all clinics are offering both yet, but Tom of P-Town Health does.
Insurance – Most private and public insurers now cover injectable PrEP, and we can help navigate any prior authorization or copay support programs.
Baseline testing – You’ll need an HIV test before each injection, as well as routine STI and kidney monitoring.
Keep your schedule – Timely injections are crucial to maintain protection and prevent resistance.
PrEP for Every Body
We’ve come a long way in HIV prevention. You now have real choices:
Daily oral pills like Truvada or Descovy
2-1-1 on-demand dosing (for some)
Cabotegravir every 2 months
Lenacapavir every 6 months
There’s no one-size-fits-all solution—but now, almost everyone can find an option that works for them.
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